Perovskite solar cells (PSCs) promise high efficiencies and low manufacturing costs. Most formulations, however, contain lead, which raises health and environmental concerns. In this review, we use a risk assessment approach to identify and evaluate the technology risks to the environment and human health. We analyze the risks by following the technology from production to transportation to installation to disposal and examine existing environmental and safety regulations in each context. We review published data from leaching and air emissions testing and highlight gaps in current knowledge and a need for more standardization. Methods to avoid lead release through introduction of absorbing materials or use of alternative PSC formulations are reviewed. We conclude with the recommendation to develop recycling programs for PSCs and further standardized testing to understand risks related to leaching and fires.